| NPI | 1831765684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: PA OT023189) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151015252) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-06-24 |